Provider enrollment is the multistep process of registering a healthcare provider and/or practice with insurance payers so they can bill and receive payment for covered services. This includes Medicare, Medicaid and any commercial plans. What are the steps in the enrollment process?
Request access to the health plan using the payer’s specified process.
Complete and submit all required applications and documentation.
The payer conducts its credentialing review, which typically takes 90–120+ days.
Once approved by the credentialing committee, the contracting phase begins. You will receive a contract outlining participation terms and reimbursement rates.
After the agreement is signed and returned, the payer issues an effective date and provider number, allowing you to begin billing and receive in-network reimbursement.
